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POSITION Maternal and Newborn Health Policy Advisor
DURATION January 2023 - December 2023
LOCATION Jakarta, Indonesia
Background
The USAID-funded Health Financing Activity (HFA) is working with the Government of Indonesia (GOI) to pilot new strategic health purchasing (SHP) arrangements for maternal and newborn health (MNH). This pilot takes place in the districts of Kabupaten Serang and Kota Serang and involves implementing new ways of contracting and paying providers for maternal health services through Jaminan Kesehatan Nasional (JKN).
The Challenge
Indonesia's national health insurance programs is one of the largest in the world, with over 80% of the country's population covered under JKN. However, the JKN payment arrangements have led to a dominance of a more costly hospital-based treatment, contributing to rapidly increasing JKN expenditures and ongoing budget deficits that threaten the sustainability of the program. The current incentives within JKN contribute to worse health outcomes by disrupting efficient service delivery. Strategic health purchasing of health services by the Social Insurance Administering Body for Health (BPJS-k) can address these issues by increasing the value for money in JKN, incentivizing more efficient service delivery patterns and higher quality of care, and thus lead to achieving better health outcomes in maternal and newborn health.
Though most pregnant women in Indonesia receive the recommended maternal care services of at least four antenatal care (ANC) visits (77%), births delivered with a skilled health worker (91%), and births in a health facility (74%), the maternal mortality ratio remains unexpectedly high at 305 deaths per 100,000 live births, one of the highest in the Association of Southeast Asian Nations (ASEAN) region. The JKN contracting and purchasing arrangements have been identified as a key contributor to this discrepancy, due to poorly designed incentives that have led to low rate of private midwife participation in JKN,
inadequate quality assurance, and lack of continuity of care throughout the whole pregnancy.
The SHP MNH Pilot
To this end, the Government of Indonesia is launching a strategic purchasing pilot for maternal health services to better incentivize providers to provide improved quality care and work towards better value for money in health. The pilot was designed by a multi-stakeholder MNH Strategic Health Purchasing Technical Working Group (TWG), convened by the Center for Financing and Health Insurance (PPJK) in the Ministry of Health. The TWG identified service delivery challenges that could be improved through better health purchasing. These included earlier detection of risk in pregnancy, referral systems and procedures, and continuity of care during pregnancy and the post-partum period. The Family Health Directorate (Kesga) of the Ministry of Health and Health Insurance and Social Security (Badan Penyelenggara Jaminan Sosial Kesehatan/BPJSK) selected two pilot districts for implementation of the pilot - Kabupaten Serang and Kota Serang
The design and implementation of the SHP pilot is supported by the USAID Health Financing Activity (HFA). Results for Development (R4D) is a subcontractor on the project and is responsible for preparing the pilot design, facilitating national and district level coordination for pilot implementation, and developing capacity building modules to improve quality in maternal health service delivery.
Consultant Role and Responsibilities
- R4D is engaging a consultant Maternal and Newborn Health Policy Senior Advisor for a 12-month consultancy (January 1st, 2023-Dec 31, 2024), with the opportunity to extend an additional 3 months (March 2024) or until the end of the pilot period. The consultant will coordinate ongoing engagement with government and nongovernment stakeholders, especially those involved in MNH policy and programming, at the national and district levels and facilitate the successful implementation of the strategic purchasing pilot for maternal health.
- Monitor pilot functioning and troubleshoot operational issues.
- Provide supportive supervision to clinical MNH providers in the intervention area to ensure care aligns with MNH service standards.
- Finalize and adapt tools for monitoring and supervision.
- Provide recommendations to the implementation team on how to solve challenges related to pilot functioning and address the needs of pilot participants.
- Support the development of technical documents, job aids, training materials and other tools necessary for pilot implementation.
- Analyze and organize next steps on troubleshooting data from health providers, health facility staff, and other pilot participants.
- Develop technical reports on pilot implementation and capacity building activities, including data analysis, data visualization, and written content in English.
- Identify, explore, and analyze lessons learned from the pilots, especially about the implications for broader health financing and strategic health purchasing policies in Indonesia.
- Support implementation research of the SHP MNH pilot.
- Make policy recommendations to the team and to stakeholders on how to improve the policy environment for strategic health purchasing and ensure pilot sustainability.
- Organize and facilitate meetings with stakeholders such as BPJSK, District Health Offices (DHO), PPJK, and donors.
- Prepare written contributions to high-level government stakeholder presentations, policy briefs, blogs, and success stories.
- The time commitment for this position is no more than 15 days per month for the duration of the contract.
- Applicants must currently live in Indonesia to apply. The applicant should also possess the following qualifications and experience:
- 10+ years working in maternal and newborn health policy, healthcare administration, government health agency, clinical healthcare, or another related field.
- Thorough knowledge of Indonesia's maternal and newborn health service standards is required.
- Demonstrated experience working with government stakeholders on issues related to maternal and newborn healthcare and policy. Experience formulating and implementing health policies in coordination with government stakeholders is desirable.
- Demonstrated experience conducting quantitative and qualitative data analysis and producing data-based recommendations.
- Advanced knowledge and fluency in Microsoft Office.
- Excellent written and verbal communication skills.
- Strong analytical and problem-solving skills.
- High level of organization, attention to detail, professionalism, proactivity, and reliability.
- Ability to travel to pilot districts Kabupaten Serang and Kota Serang.
- Fluency in Bahasa Indonesia and English is required.
- To apply for this consultant position, please send the following documents to
- Short cover letter describing your interest in this position, relevant experience, and requested daily rate of pay
- Please include “MNH Consultant - HFA - Your Name” in this subject line of the email.
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